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� S� 92�s <br />ELE�TRICAL PERMIT APPLICIB►TiON <br />CITY OF EVEFtETT PERMiT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereriwa.org <br />APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />')�i !nY� �% �G�� 98'�03 <br />,. , � � <br />PROJECT ADDRESS <br />r r.c/ � /1 <br />owner <br />Tenant <br />�nrvr <br />Mail Address <br />Mail Address <br />ciry <br />ciry <br />�oo ;� �6 � /�e (/�. <br />�=���frJ - c.� -�r - �" �.� � <br />Mai1 Address City <br />Electrical Contrador �// /��7 <br />�I� c 1 � � IIDGfI l <br />State License Number <br />, <br />�'rr). j .. �r' dGnce- <br />'' — <br />Proposed Use nf Building � <br />.,��.i-.�, - �c! <br />Description of Work to 8e Done: i'�� `� ' <br />NOTE: BERN RACEWAYS MC OR AC CAB�UIRED TO <br />Slate2ip <br />Phone <br />Stale2ip Phone <br />yas-���- �, �5 7 <br />_ __ ,.�a y o�S'3 <br />Stale2ip <br />�g/ ��p <br />Contract Price of Work <br />t� <br />���✓��, U %i+� e <br />Contac[ Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily that I have read and examined Phis applicafion and know the same to be true and <br />correcL All prowsions of laws and ordinances governing fhis type opf work will be. canpfeted <br />violaeeor Pan el�he prov sions ol any other 9 at �oca! la�v re9ulating onstruc bn o theY t� <br />per(ormance of cons(ruction. That 1 am authaized by the owner o� this property to perform the <br />�vork �or which apolicahon is made and 1 comply with the Stafe Contracfors Law 18.27 RCW and <br />296 200 WAC. <br />% � ---- <br />FEE <br />Phone <br />rv�► c l -a�( `1 <br />